Nursing care dependency of the hospitalized elderly: a cross sectional study

Fabiana Medeiros de Brito1, Maria das Graças Melo Fernandes1
1Paraíba Federal University


Aim: To verify the degree of dependency on nursing care on the part of hospitalized elderly inside a clinical practice unit by using the Perrocas’ System for Patient Classification. Methods: a cross sectional study, undertaken with 112 elderly patients in a clinical practice unit at a teaching hospital at João Pessoa/PB. Results: It was observed that most elderly patients presented a high level of dependency on nursing care. A statistically significant association between high dependency levels and the socio-demographic variable of previous occupation was identified. Conclusion: the empirical results obtained in this research are crucial to our understanding of the dependency of elderly hospitalized in clinical practice units, as well for the development of similar studies focusing on elucidating this dependency in order to help improve elderly patients’ quality of life.

Descriptors: Dependency; Elderly; Nursing Care; Hospitalization.


Care dependency is a dynamic and non-permanent process which can be modified, prevented and/or reduced. It indicates a demand for assistance focusing on the whole-patient and his/her needs. The hospitalized elderly patients’ high levels of dependency when carrying out the Activities of Daily Living (ADL), such as taking baths, getting dressed, ambulating, having bowel control and eating a meal by themselves, indicates an increased need for nursing care(1). In spite of this, it is worth noting that the Patient Classification System (PCS) is a resource that seeks to classify patients in order to identify the amount of assistance required(2), consequently contributing to the development of an effective nursing care plan aimed at supporting hospitalized elderly patients(3).

In terms of this perspective, the following guiding question emerged: what is the degree of nursing care dependency on the part of hospitalized elderly patients?


To verify the degree of nursing care dependency on the part of hospitalized elderly patients in a clinical practice unit by using Perroca’s System for Patient Classification.


This is a descriptive, epidemiological study which has adopted a cross-sectional approach. The study was carried out in the clinical practice unit of a teaching hospital located in the city of João Pessoa, in the state of Paraíba. The sample consisted of 112 elderly patients. Data collection took place between the months of April and June 2015 through the use of semi-structured interviews, a questionnaire gathering socio-demographic and clinical aspects relevant to the research, and patient classification variables based on Peroca’s classification method(2). Data were compiled and analysed using a quantitative approach, through descriptive statistical analysis, logistic regression and tests of association. The project was approved by the Comitê de Ética do Centro de Ciências da Saúde da Universidade Federal da Paraíba (Paraíba Federal University Health Sciences Ethics Committee), under Protocol nO 0668/2014.


The study revealed a prevalence of female elderly people (69.6%), aged between 60 and 70 years (34.8%), widows and widowers (48.2%), caucasians (44.6%), with one to three years of schooling (43.8%), an average income of up to two minimum wages (92.0%) and retirees/pensioners (85%). Regarding the clinical aspects, it can be verified that 55% of the patients remained in the hospital for less than a week; the same proportion were admitted due to conditions such as systemic arterial hypertension (68.8%), diabetes (43.8%), pneumonia (34.8%) and urinary tract infection (18.8%).

It was demonstrated, in particular, that according to the evaluation method used, 34% of the elderly patients who took part in the research were in the semi-intensive care category, and 33% were in the intensive-care one, revealing a high degree of nursing care dependency. Taking into account the possibility of statistical associations between elderly patients’ socio-demographic variables and their degree of nursing care dependency, a meaningful association with the variable “previous occupation” (p = 0.017) was found to exist.


In order to determine the patient’s nursing dependency, one must consider the importance of the professional evaluation, the purpose of which is to identify the patient’s multidimensional needs, besides providing scientific foundation for targeting behaviors and implementing care interventions(4). In this context, it is important to highlight that nursing staff must be both qualitatively and quantitatively prepared for answering the hospitalized elderly patients’ needs, especially regarding care dependency and taking into account its relation with sociodemographic variables such as work SEE ABOVE.


Based on the above considerations, it can be concluded that the empirical results obtained as a result of this research appear as relevant variables connected with the dependency of hospitalized elderly patients in clinical practice units. It also contributes to the possible development of similar studies aiming to clarify this dependency and to provide support for a better quality of life for elderly people.


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  4. Bittencourt GKGD, Crossetti MGO. Critical thinking skills in the nursing diagnosis process. Rev. esc. enferm. USP [Internet]. 2013 Apr [cited 2016 Apr. 12]; 47(2):341-7. Available from:

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Received: 08/15/2016 Revised: 08/16/2016 Approved: 08/30/2016